The effect of mHealth on vaccine uptake, coverage, and acceptance among children, adolescents and adults: A meta-analysis

ABSTRACT

Background@#This meta-analysis was conducted to synthesize the evidence on the effectiveness of mhealth for vaccination uptake, coverage, and acceptance among children, adolescents, and adults.@*Methods@#Database search was conducted in PubMed, Medline, and Cochrane Library. Studies were included if the following were met: 1) RCTs or CCTs, and 2) with comparison of mHealth on usual care. Studies were excluded if mHealth was not assessed and the data were insufficient to calculate pooled results. The effectiveness was evaluated using Odds ratio with 95% confidence interval in RevMan 5.3.@*Results@#A total of 17 studies were included in the analysis. The pooled analysis showed that mHealth can improve vaccine uptake (OR 1.83, p=0.0005), coverage (OR 1.49, p=0.03), up-to-date vaccination (OR 2.37, p=0.0007), and completion of full vaccine series (OR 1.81, p=0.0002). Subgroup analyses showed that vaccine uptake is significantly improved when text messaging is used as a reminder system (OR 1.73, p<0.001) and when mHealth is employed for children’s vaccines (OR of 2.77, p=0.007). Majority of the pooled studies showed significant heterogeneity. Statistical synthesis on vaccine acceptance was not feasible, but existing studies report positive effects of mHealth on this outcome.@*Conclusion@#mHealth can improve vaccine uptake, coverage, up-to-date vaccination, and completion of the full vaccine series. Additional unpublished and rigorous studies may be considered in a future research to fully assess its effectiveness.